Estrategia educativa de enfermería para facilitar el seguimiento y verificación del cuidado del catéter central de inserción periférica (PICC) en una unidad de cuidado intensivo de una institución de cuarto nivel de la ciudad de Bogotá

Abstract

En los últimos años el uso rutinario de los catéteres centrales de inserción periférica (PICC), ha ido aumentando cada vez más, Sin embargo, dentro de las complicaciones derivadas de la implantación de los catéteres vasculares de inserción periférica (PICC), se encuentra la infección, por lo anterior según los datos suministrados por el Instituto nacional de salud (INS) en el Periodo epidemiológico XIII Colombia 2020 afirma que: existieron 6857 número de casos de infecciones asociadas a dispositivos en cuidado intensivo con un aumento del 30% comparado con el 2019 y específicamente para infecciones asociadas al torrente sanguíneo 3.6 Casos por 1000 días catéter central.

In recent years, the routine use of peripherally inserted central catheters (PICC) has been increasing more and more. However, infection lies within the complications derived from the implantation of PICC. Therefore, according to data provided by the National Institutes of Health (NIH), in the epidemiological period XIII Colombia 2020 affirms that: there were 6,857 cases of infections associated with devices in intensive care with an increase of 30% compared 2019 and specifically for infections associated with the bloodstream, 3.6 Cases per 1000 days central catheter. OBJECTIVE: Implement a nursing educational strategy to facilitate the monitoring and verification of the care of PICC in patients who are in an intensive care unit of a fourth level institution in the city of Bogotá with the participation of the patient and their family. MATERIALS AND METHODS: Nursing care management project guided by the logical framework methodology using reports or data provided by the epidemiology department to evaluate adherence to protocols. Developing a nursing strategy based on the theoretical model of institutional nursing; For socialization, a pre and post questionnaire was used as an evaluation in 16 nursing professionals, as well as the use of an instrument to evaluate educational tools. RESULTS: The percentage of adherence to PICC maintenance protocol: yearly second quarter (April - June 2021) was 73.33% and the percentage of PICC infection was 6%, if compared to the previous quarter, this maintains a significant increase since the percentage of PICC infection was 1.2%. In relation to the percentage of adherence to the healing process it was 81.08%. In addition, there is evidence of a deficit in the indicator for hand washing, with 85% adherence to the protocol being the minimum indicator. The intensive care unit is at 83.51% adherence. With the development and execution of the strategy, it was possible to strengthen the level of knowledge in the professionals regarding the insertion and maintenance of the PICC. CONCLUSIONS: The educational component and the creation of strategies have a direct and positive impact on the performance of professionals. In this project the positive impact generated in the nursing staff can be evidenced in the follow-up and verification of the care of the PICC, allowing the implementation of evidence-based practice for the consolidation of knowledge and skills of professionals and continuous improvement in the quality of care provided. In addition, the process of family participation and nursing practices allowed the gradual bonding of the family member in care, which depended on the possibilities promoting and facilitating the recovery of the patient.